Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, 7057, 1007 MB, Amsterdam, The Netherlands.
Oral Oncol. 2010 Jan;46(1):56-60. doi: 10.1016/j.oraloncology.2009.11.001. Epub 2009 Dec 9.
To investigate employment in working-age head and neck cancer (HNC) survivors before and after treatment in relation to sociodemographic and clinical factors, health related quality of life, and emotional distress. Patients younger than 65 years at time of diagnosis and at least 2 years after curative treatment for HNC were included. Exclusion criteria were cognitive dysfunction and no understanding of Dutch language. Primary outcome measures were employment status and return to work assessed by a study specific questionnaire. Secondary outcome measures were health related quality of life (EORTC QLQ-C30 and QLQ-H&N35) and emotional distress (Hospital Anxiety and Depression Scale (HADS)). Sociodemographic and disease and treatment related parameters, health related quality of life, and distress were compared to employment status. Eighty-five out of 113 included patients completed the questionnaires (response rate 75%). At time of diagnosis 32 patients were not working (38%), significantly associated with (higher) age and (lower) education level. Of the 53 patients who were employed at time of diagnosis, 44 patients returned to work (83%): 28 to the same work, 7 to adapted work and 9 to other work. Median time was 6 months to return to work (range 0-24 months) and 71% of the patient returned to work within 6 months after treatment. Anxiety and oral dysfunction as xerostomia, trismus, sticky saliva, problems with teeth, and loss of appetite, problems with social eating and social contacts were significantly associated with employment after treatment. The majority of employed HNC survivors return to work within 6 months after treatment. Oral dysfunction, loss of appetite, deteriorated social functioning, and high levels of anxiety are barriers for HNC survivors to return to work after treatment.
为了调查治疗前后工作年龄段头颈部癌症（HNC）幸存者的就业情况与社会人口学和临床因素、健康相关生活质量和情绪困扰的关系。诊断时年龄小于 65 岁且 HNC 治愈性治疗后至少 2 年的患者被纳入研究。排除标准为认知功能障碍和不理解荷兰语。主要结局指标为通过特定于研究的问卷评估的就业状况和重返工作岗位的情况。次要结局指标为健康相关生活质量（EORTC QLQ-C30 和 QLQ-H&N35）和情绪困扰（医院焦虑和抑郁量表（HADS））。将社会人口学和疾病及治疗相关参数、健康相关生活质量和困扰与就业状况进行比较。113 名纳入患者中有 85 名完成了问卷调查（应答率 75%）。诊断时，32 名患者未工作（38%），与（较高）年龄和（较低）教育程度显著相关。在诊断时就业的 53 名患者中，44 名（83%）患者重返工作岗位：28 人回到原来的工作，7 人从事适应工作，9 人从事其他工作。重返工作岗位的中位数时间为 6 个月（范围 0-24 个月），71%的患者在治疗后 6 个月内重返工作岗位。治疗后，焦虑和口腔功能障碍，如口干、张口困难、唾液粘稠、牙齿问题、食欲不振、社交进食和社交接触问题与就业显著相关。大多数就业的 HNC 幸存者在治疗后 6 个月内重返工作岗位。口腔功能障碍、食欲不振、社会功能下降和焦虑水平升高是 HNC 幸存者治疗后重返工作的障碍。
